美容性文身引发结节病

Background: The development of granulomatous lesions within tattoos is a well-recognized occurrence in individuals with sarcoidosis. The characteristic histopathological finding of sarcoidosis is the presence of noncaseating granulomas; however, similar histopathogical findings may be seen in foreign body granulomas. Several reports have challenged the assertion that the presence of foreign material within sarcoidal granulomas is incompatible with a diagnosis of sarcoidosis. Observations: We describe a patient who had multiple linearly arranged papules along her eyebrows and the vermillion border of her upper lip. She had had cosmetic tattooing performed on these areas 3 year prior to presentation. Histopathologic examination revealed sarcoidal granulomas, polarizable foreign material, and pigment granules. Hilar adenopathywas noted on a chest radiograph. After 4 months of treatment with a midpotency topical steroid and doxycycline, she experienced complete clearance of her cutaneous lesions and normalization of chest x-ray film findings. Conclusions: This case demonstrates a unique adverse result after cosmetic tattooing and highlights the concept that granulomatous histopathologic findings containing foreign material should not be an exclusionary criterion for the diagnosis of sarcoidosis. In this setting, further investigation for the presence of systemic disease is indicated.

再谈Jadassohn皮脂腺痣重建的选择

Background: Nevus sebaceus of Jadassohn (NS) has the classic presentation on the head and neck of a yellow-orange-colored, waxy, pebble-like, papule or plaque. Its reported malignant potential varies between 0.8% and 50% . The common location of NS on the temporal hairline leaves a cosmetic defect. Methods: We retrospectively reviewed a consecutive series of patients with NS located in the temporal scalp region. Thirteen patients were included. Twelve patients were reconstructed with a temporal flap. One patient had a primary linear scalp closure after excision. Clinical, histopathologic, surgical, and photographic records were used to review the clinical, anatomic, and pathologic presentation of the lesions. Reconstructions were rated on a scale of 1- 5 by two independent examiners. The cosmetic results were also assessed by the patients. Results: Patients ranged in age from 3 to 40 years. All of the lesions were located in the temporal area of the scalp. All cases were pathologically determined as NS. Two cases contained basal cell carcinoma (15% ).Two cases were re-excisions of confirmed NS. One case was excised and closed with difficulty using a linear primary closure. Rotation flaps based on the superior temporal artery were used for the reconstruction of the defects in 12 patients. Nine of the flaps were anterior rotation flaps and three were posterior. The average score for the cosmetic results of the patients was 3.75, with the lowest score being 2, and the highest 5. The score for the linear closure was 2. Conclusion: A rotation flap based on the superficial temporal artery is an excellent reconstructive solution for NS located in the temporal scalp region.

在北魁北克的因纽特人患经典型卡波济肉瘤

Classic Kaposi’ s sarcoma (KS) is predominantly a disease of eastern Mediterranean and Ashkenazi Jewish elderly men. Nevertheless, the disease has been reported to occur in people from various other ethnic and regional backgrounds. We report, for the first time, the occurrence of classic KS in five Inuit people living in northern Quebec, Canada. We describe the case of a 69- year-old Inuit man with classic KS, and report four other cases of KS in the Inuit population, identified by a review of our hospital’ s dermatopathology records. The discovery of classic KS in the Inuit population of northern Quebec brings with it new questions as to the origins of the KS-associated herpes virus in this population. It is our belief that the answers to these questions are in the genotype of the virus that is present in this community.

使用激光捕获显微切制法对黑色素患者及其配偶的黑素细胞痣CDKN2A/p16INK4a突变的研究

Objective: To determine the frequency at which the CDKN2A coding region is mutated in the atypical nevi of persons with sporadic melanoma. Design: DNA samples, isolated by laser-captured microdissection of atypical nevi from 10 patients with newly incident cases of sporadic melanoma and their spouses as matched controls, were used as templates for nested polymerase chain reaction amplification of CDKN2A exons 1 and 2. Results: No point mutations in the coding region of CDKN2A were observed in any of the melanocytic nevi. Conclusions: Point mutations in CDKN2A are an uncommon event in the atypical nevi of persons with melanoma. As such, the data may support a hypothesis of melanocytic nevus histogenesis, in which the melanocytic nevus and malignant melanoma represent separate, pleiotropic pathways resulting from common stimuli, such as genomic damage from UV radiation.

英国、哥伦比亚和加拿大的黑素瘤筛查

Background In several studies, delays in malignant melanoma (MM) diagnosis have been correlated with increased tumor thickness, increased morbidity, and increased mortality. Objective We sought to assess how MM is detected in British Columbia, Canada, and to understand the role of patient education and other factors on diagnostic delays. Methods A self-administered questionnaire was distributed to 176 consecutive patients with histologically confirmed MM. Results The total median delay was 4 months. There was no correlation between tumor thickness and delay times. Lesions found incidentally by physicians were less invasive (median Breslow thickness 0.59 vs 1.0 mm, P=.006) than those found by patients. The majority of patients had some knowledge of MM and recognized the importance of early detection. Nearly one fourth of respondents were unaware MM could develop from a melanocytic nevus. In general, MM knowledge did not affect total delay. Conclusion Patients in British Columbia, Canada, report relatively short delays in diagnosis of MM. Delays were not correlated with increased tumor thickness or with patient knowledge regarding melanoma before diagnosis.

光动力疗法治疗酒渣鼻

Background: Rosacea is a common disease, with an estimated prevalence of 5-10%. Established systemic and topical treatment is often effective but requires continuous medication. Aim: We report the outcome of photodynamic therapy (PDT) in 4 patients with rosacea. Methods: Prior treatment consisted of standard treatment with tetracycline and metronidazole. The treatment was however either ineffective or the patients were dissatisfied with the need for continuous treatment. The patients all received standard treatment with PDT. Results: The treated skin cleared in 3 of the 4 patients. Treatment with light alone did not appear to have any effect. In one of the patients there has been no relapse during a 9-month follow-up. In 2 patients, remissions lasted 3 months, during which time no additional or supplementary treatment was used. Conclusion: Our observation suggests that PDT may play a role in the future treatment of selected cases of rosacea.